Stepping Up: Three Steps to Identifying and Collecting ... · reviews for all seriously mentally...

THREE STEPS TO IDENTIFYING AND COLLECTING DATA ON PEOPLE WITH

MENTAL ILLNESSES IN YOUR JAIL

May 2019

#StepUp4MentalHealthwww.StepUpTogether.org

Speaker: Nastassia Walsh

Nastassia Walsh

Program Manager

National Association of Counties

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Logistics

#StepUp4MentalHealthwww.StepUpTogether.org

We are Stepping Up!

Calls for counties to:

✓ Use the Stepping Up Self-Assessment Tool to identify existing gaps in your Stepping Up efforts

✓ Pick at least one priority for your county to fully implement over the next six months

✓ Use the Stepping Up resources to reach your goals

✓ Participate in the Stepping Up Month of Action in May

✓ Share your progress toward meeting your goals in July

Stepping Up our Efforts

Speaker: Lindsey Fox

Lindsey Fox

Development Officer, Corporate and Foundation

Relations

American Psychiatric Association Foundation

GOALS:1. Bring more attention

to the important work you are doing

2. Bring awareness on the importance of

supporting individuals with SMI

“Stepping Up is a movement and not a moment in time”

8

Month of

Action!

Calls for Counties to:

Demonstrate their impact and highlight their efforts toward reducing the number of people with mental illnesses in jails.

Month of

Action!

Utilizing May as Mental Health Month you will:Highlight the progress your county has made with its Stepping Up effortsShowcase your county’s Stepping Up team Share experiences of people impacted by your county’sStepping Up effortsEncourage your peers and peer counties to “Step Up” for mental health

Week 1 ( May 5 – 11)Highlight the progress your county has made with its Stepping

Up efforts

Pass a proclamation about participating in the Month of Action

Host an event to highlight progress in your community

Share a press release highlighting your county’s progress

Create an infographic, slide show, or video about your efforts

Submit op-eds or articles to local outlets highlighting impact

Week 2 ( May 12 – 18)Show case your county’s Stepping Up team

Post a photo of your county’s Stepping Up team

Create a video with interviews of Stepping Up team members

Create or promote your county’s Stepping Up website

Share stories on why your Team members have “Stepped Up”

Don’t forget to use the hashtag #StepUp4MentalHealth

Week 3 ( May 19 – 27)Share experiences of people impacted by your county’s Stepping

Up efforts

Create a video interviewing people impacted by your work

Share photos and stories of people impacted by your work

Share a blog post on your county’s website by a person impacted

Work with your local NAMI chapter to engage individuals


Week 4 ( May 28 – June 1)Encourage your peers and peer counties to “Step Up”

for mental health

Send a letter to non-Stepping Up county encouraging them to join

Publish articles in your state news about the need for change

Share video testimonials and tag non-Stepping Up counties

Participate in the Stepping Up twitter chat May 30 12pm – 1pm


Speaker: Risë Haneberg

Risë Haneberg

Senior Policy Advisor

Council of State Governments Justice

Center

•Calls for a paradigm shift:• Move beyond programs and pilots to scaled impact and measurable

reductions in prevalence

•No-nonsense, data-driven public management:

• Systematic identification of mental illnesses in jails

• Quantification of the problem

• Scaled implementation of strategies proven to produce results

• Tracking progress and adjusting efforts based on a core set of outcomes

The Council of State Governments Justice Center | 15

123456

Is our leadership committed?

Do we conduct timely screening and assessments?

Do we have baseline data?

Have we conducted a comprehensive process analysis & inventory of services?

Have we prioritized policy, practice, and funding improvements?

Do we track progress?


1. Reduce the number of people who have mental illnesses booked into jails

2. Shorten the length of stay in jails for people who have mental illnesses

3. Increase connection to treatment for people who have mental illnesses

4. Reduce recidivism rates for people who have mental illnesses

Systems-Level, Data-Driven Changes Should Focus on Four Key Measures


Goal: Every County Has Accurate, Accessible Data

Recommended approach for accurately identifying

people who have SMI in jail:

1. Establish a shared definition of SMI for your Stepping Up efforts that is used

throughout local criminal justice and behavioral health systems

2. Use a validated mental health screening tool on every person booked into

the jail and refer people who screen positive for symptoms of SMI to a follow-

up clinical assessment by a licensed mental health professional

3. Record clinical assessment results and regularly report on this population

Having accurate and timely data is critical for counties to know the scale of the problem, develop a strategic action plan that effectively targets scarce resources, and tracks

progress


The initiative recognizes that there may be more counties that are using or committed to using the three-step recommended approach to have accurate, accessible baseline data and want them to join this cohort!

Pacific

Calaveras

DouglasJohnson

Champaign

Miami-Dade

Franklin

11 Stepping Up Innovator Counties Recognized for Having Accurate, Accessible Data


Hennepin

Polk

Lubbock

Berks

Prioritizing System Improvements

• Police-Mental Health Collaboration programs

• CIT training• Co-responder model• Crisis diversion

centers• Policing of quality of

life offenses

• Expand community-based treatment & housing options

• Streamline access to services

• Leverage Medicaid and other federal, state, and local resources

• Routine screening and assessment for mental health and SUDs in jail

• Pretrial mental health diversion

• Pretrial risk screening, release, and supervision

• Bail policy reform

• Apply Risk-Need-Responsivityprinciple

• Use evidence-based practices

• Apply the Behavioral Health Framework

• Specialized Probation

• Ongoing program evaluation


1. Jail Bookings

3. Connection to

Treatment

4. Recidivism

2. Jail Length

of Stay

Speaker: Lubbock County, Texas

Kelly Rowe

Sheriff, Lubbock County Sheriff’s Office

Lubbock County, Texas

Sheriff Kelly Rowe

• Lubbock, Texas estimated population 305,000 (2017)

• 1512 Bed Direct Supervision Facility

• Average Daily Population 1200• Currently participating in Jail

Based Competency Restoration Program

• Specialized housing for mental health inmates

• Designated site for about 30 Masters level interns in the field of counseling

• Average of 96 inmates meet the definition of SMI

Mental Health Screening and Assessments

• Screening is completed upon intake for each inmate; this screening indicated risk for suicide, medical, mental impairments.

• https://www.tcjs.state.tx.us/docs/ScreeningForm-SMMDI_Oct2015.pdf

• This form was promulgated by the Texas Commission on Minimum Jail Standards.

• In addition to this screening form, our Local Mental Health Authority, StarCare, is contracted by the facility and provides a secondary screening and any required assessments.

https://www.tcjs.state.tx.us/docs/ScreeningForm-SMMDI_Oct2015.pdf

• As a part of the Justice and Mental Health Collaboration; stakeholders through the service area collaborated and agreed upon a definition of Serious Mental Illness that would be used for research purposes.

• Each individual stakeholder maintains the ability to define serious mental illness for their own services, the agreed upon definition was solely for research purposes.

Electronic Tracking

By using our Jail Management System, the contracted StarCare employees, flag individuals who meet the agreed upon definition of serious mental illness.

Sheriff Kelly Rowe

Speaker: Berks County, Pa.

Pamela Seaman

Deputy Administrator for Adults

Mental Health and Developmental

Disabilities Program

Berks County, Pa.

Justin Loose

Chief Information Officer

Information Systems Department

Berks County, Pa.

Dr. Emily Scordellis

Mental Health Regional Manager

PrimeCare Medical, Inc.

Stepping Up – Berks County

A Work in Progress

Webinar presentation May 2, 2019

Berks County, PA

Population: 420,152 (2018)

ADP: 1,104 (2018)

Diversions: 461 since 2012

Arriving at a Common Definition for Serious Mental Illness

• Existing definitions utilized by Pennsylvania Department of Corrections and Pennsylvania Department of Human Services/OMHSAS (prior to aligning with revised Federal Definition of Serious Mental Illness) for priority population was already common place

• Mental Health Bulletin OMH-94-04 identified the Adult Priority Group as:

• 18 or older with a diagnosis of schizophrenia, major mood disorder, psychotic disorder NOS or Borderline Personality Disorder with additional treatment history, functional impairment or co-existing history or circumstance

Berk County Jail System

• Starting place for data collection and analysis

• Already utilizing the Mental Health Stability Rating Scale (MHSR) which provides a four-point scale classification (A,B,C,D) for any inmate presenting for evaluation by the mental health team

• Classification D- Includes inmates diagnosed with a Serious Mental Illness (SMI) and or exhibiting significant adjustment /behavioral concerns. SMI diagnoses include Schizophrenia, Schizoaffective Disorder, Major Depressive Disorder, Bipolar Disorder, Unspecified Psychotic Disorder and Borderline Personality Disorder

Considerations and Future Direction with SMI Definition• System partners recognize the use of this common definition

for the exclusive purpose of this project

• All partners continue to use a definition for their mentally ill target population outside of Stepping Up to continue work within their designated areas. For example, Mental Health/Developmental Disabilities does not limit diversionary interventions to only those with SMI (according to this priority population definition)

• Future direction with regard to this common definition may change/further develop with the sophistication of data collection and analysis

Assessment at Admission

• Comprehensive medical and mental health screenings are completed within 4 hours of admission to the jail by trained medical professionals

• 4 hour window allows for prompt medication verification and assessment of clinical needs

• EMR tracks previous level of mental health care during past admissions

• Validated assessment tools are utilized in addition to self report questionnaires

• Correctional Mental Health Screen for Men and Women• Public domain assessment tool• CMHS-W 75.0% validity; CMHS-M 75.5% validity• Cut off scores utilized to determine if a patient is referred to the mental health team

Assessment Post Admission

• All referrals to the mental health team are completed within 24-72 hours of admission with appropriate referrals for continued mental health follow-up and/or psychiatry follow-up generated at time of assessment

• Seriously mentally ill inmates meet with mental health staff consistently throughout their incarceration

• SMI patients on specialty housing units are seen by mental health staff 5 days per week and offered group therapy opportunities

• SMI patients on non-specialty housing units are seen by mental health staff at a minimum of every 30 days

• Patients who are incarcerated for 90 days who have not already been evaluated are referred to mental health for assessment

Collaboration and Continuity of Care

• Medical and mental health staff have daily case conference meetings to discuss seriously mentally ill and/or difficult to manage patients

• Medical, mental health and security staff hold weekly interdisciplinary team meetings to discuss seriously mentally ill patients

• Medical, mental health and administrative staff conduct monthly reviews for all seriously mentally ill patients

• Multidisciplinary meetings are held monthly to discuss case disposition and discharge planning

• Warden, Deputy Warden of Treatment, Custody Lieutenant, correctional medical and mental health staff, county MH/DD staff, Adult Probation, District Attorney’s office, Public Defender’s office, local service providers

Data Analytics: Driving Insight and Oversight

• Leverage the use of OpenLattice technology to obtain overall performance and health data of the criminal justice and human service systems

• Perform basic descriptive analytics to look at groups that are over or under represented in the system

• Track overall performance measure for specific groups

• Assist groups in understanding or validating gaps in the system including:

• Data entry issues• Population segments that underperform• System gaps

Berks County Contacts

Emily Scordellis, Psy DMH Regional [email protected]

Pam Seaman, MPADeputy Administrator for Adults610-478-3271, ext. [email protected]

Justin Loose, CISSPChief Information Officer610-478-6175, ext. 6194

[email protected]

Edward B. Michalik, Psy DStepping Up Project Lead610-478-3271, ext. [email protected]

mailto:[email protected]




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